Dear Nurse Jane and Webmd staff,
I inserted a Mirena this January and have been having reccurent yeast infections since April. What can I do to stop this? I thought it was because my job had me wearing pants that were lined, but I cut out all the liners; what do you recommend? A friend suggested acidophillus,
Thanks in advance
Besides this issue, mirena has been great
Dear Anon: There is a subgroup of women who have chronic and recurrent yeast infections. It is important to document that these infections are truly candida (yeast). Other infections such as lactobacilli vaginitis can masquerade as yeast, but yeast medications will NOT provide any lasting relief. Certain dermatologic conditions of the vulva can have symptoms which mimic yeast (eg lichen sclerosus).
If a woman has proven recurrent yeast, by either vaginal fungal culture or wet mount preparation, then some additional testing can be done to see if a predisposing medical condition (eg diabetes, HIV) is the culprit.
So is the Mirena a culprit in some way? DepoProvera (high dose synthetic progesterone) can decrease beneficial hydrogen peroxide producing bacteria within six months of use. There can also be a slight thinning of the tissues which keep vaginal pH acidic (Miller, 2000). Your Mirena does put some additional progesterone into the body but not to the degree as DepoProvera. The use of a copper IUD has been linked to increased bacterial vaginosis ("BV") in four studies--but not yeast infections. So I cannot find data to suggest that Mirena is commonly linked to increased yeast infections.
Women with chronic yeast may be treated with a variety of options. A change of prescriptive yeast treatment may be tried. Use of other medications which can predispose women to candida (eg steroids, chronic oral antibiotics, or even birth control pills) may need to be re-examined. Some healthcare providers will use treatments like vaginal boric acid capsules for either treatment or prevention in the cases of resistant vaginal yeast.
Additional lifestyle methods, which have been advocated for "yeast infection prevention," include: a diet low in refined sugars and simple carbohydrates, avoidance of tight jeans, use of cotton underwear, eating natural lactobacillus yogurt, and others. There are few, if any, good research studies which demonstrate that these methods are helpful, but some women swear by them.There is even the suggestion that being the recipient of oral sex may predispose a woman to recurrent yeast (Reed, 2000).
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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